KEY INFORMATION WHILE ON CAMPUS AT CVMC Coosa Valley Medical Center is dedicated to providing our community with comprehensive health services that enhance the health and wholeness of each individual we serve through medical and spiritual support while affirming their personal value and dignity. 1
We are committed to making your stay here as comfortable as possible. If any concerns arise during your stay or you would like to pass along any suggestions or compliments please give us a call at the number below and ask to speak to the administrator on call.
CVMC Administrator on Call: (256) 401-4000 If you need further assistance or are unable to resolve your concerns, you may contact the Alabama Department of Public Health or The Joint Commission.
Alabama Department of Public Health: 1-800-356-9596 Complaint Department Suite 600 RSA Tower 201 Monroe St. Montgomery, AL 36104 The Joint Commission One Renaissance Blvd, Oakbrook, IL 60181 www.thejointcommission.org (Then click “Report a Patient Safety Event�) FAX: 1-630-792-5636 2
A PATIENTS BILL OF RIGHTS AND RESPONSIBILITIES Coosa Valley Medical Center’s medical staff and team members want to help enhance your health, dignity, and wholeness. In support of our mission, we hereby adopt this Patient Bill of Rights and Responsibilities.
You Have the Right to: 1. Be treated in a dignified and respectful manner that supports your dignity 2. Proper treatment for you health condition without regard to your race, creed, gender, gender identity or expression, age, religion, language, sexual orientation, culture, physical or mental disability, country of origin, or source of payment for your care. 3. Participate in a treatment plan of care and be informed and make decisions about your medical condition, treatment, and outlook in terms that you can understand. 4. Make choices about your own care, including the right to request care, and the right to select a representative to be involved in care, and the right to withdraw or deny these rights orally or in writing at any time. 5. Expect we will listen to and address your pain concerns. 6. Have the right to withdraw or refuse treatment as allowed by law and to understand the risk and benefits of refusal. 7. Have your family or your caregiver notified of your admission to the hospital. 8. Have your personal physician notified of your admission to the hospital. 9. Make an advance directive, including a living will and/or power of attorney for health care. The hospital will ask you about this when you are admitted. You also have the right for your caregiver to follow your advanced directive. Your Advanced Directives will be honored in all areas except the outpatient settings. 10. Privacy of your medical records and details about your care. 11. Access information in your medical records, request amendment to, and obtain information on disclosure. 12. Personal privacy and confidentiality. 13. Care in a safe setting and facts about the use of safety items, such as restraints. 14. Be free from all forms of abuse, neglect or harassment from staff, visitors, or other patients. 15. Be told of business ties between the hospital and your other caregivers. 16. Know that the hospital will give you the best care it can. You may be asked to move to another hospital or place of treatment. If so, you will be told your choices and what could happen with those choices. 17. Say yes or no to being a part of research or clinical trials. 18. Be told about how to continue your care upon your discharge from the hospital and make choices about what agencies/services will be required post-discharge. 19. Be told of the hospital’s rules. 20. Receive a copy of your bill. 21. Be told of how and to whom you may voice a complaint. 22. To receive visitors and have a support person, designated by you for emotional support during your course of stay. 23. Have your cultural, personal values, beliefs, and preferences respected. 24. Religious and other spiritual services. 25. Have and restrict visitors. Visitors may be restricted for the following: Infection control issues (flu symptoms, etc.), interference with care of other patients, a court order restricting contact, visitors being disruptive or threatening, patient roommate needs rest or privacy, protocols in psychiatric treatment.
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A PATIENTS BILL OF RIGHTS AND RESPONSIBILITIES You are Responsible For: 1.
2. 3. 4.
5. 6.
Letting the hospital know about any medicines you are taking at home, your medical history and your present medical problems. You should tell the doctors or nurses about any changes to your medical problems while you are in the hospital. This includes telling your doctors or nurses you are in pain and any other information that facilitates care, treatment and services. Giving the hospital a copy of your advance directive, if you have one. Asking questions when you or your family do not understand what you have been told about your medical condition, your treatment or what you should do to care for yourself. Following instructions, including your plan of care as developed by your health care team. Your plan of care includes the effect of lifestyle on your health. You are responsible for accepting the consequences of not getting treatment or not following the instructions of your caregivers. Showing respect for other patients and the hospital staff. This includes treating hospital belongings with respect. Paying your hospital bill. This includes giving the hospital correct information about your insurance or how you intend to pay your bill.
The rights and responsibilities can and should be exercised on the patient’s behalf by a parent, guardian, designated surrogate, or proxy decision-maker if the patient lacks decision-making capacity, is legally incompetent or is a minor.
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Manage your health online... Thank you for choosing Coosa Valley Medical Center as your provider of medical services. Our goal is to provide you with excellent care and hospitality. In compliance with the federal government’s Meaningful Use Initiative, all hospitals will soon be required to provide patients (and/or a patient-authorized user) access to their patient record electronically. Having this electronic access through your personal, secured email will allow you as the patient the ability to review your medical record during your stay here at our facility. This access provides you with information, including but not limited to, medical procedures completed., medical history, medications taken, allergies, existing or developing medical conditions, etc. You can also download your confidential medical record to your own private computer for your personal records, as well as electronically share your record with another medical professional of your choice if there is a need. Upon your discharge from our hospital, the email address you shared with us during the registration process will receive an auto-generated email from our electronic health record. This email will direct you to step-by-step instructions on how to access your personal medical record. If you have not already given an email address to us, you may do so prior to discharge, just notify our staff that you wish to do so.
Portal: A Step-by-Step Process Step 1—You will receive an email invitation to create your patient portal account. Click the link in the email to start the registration. You will receive an email from donotreply@cvhealth.net, if you believe you should have received an email and have not, please check any spam or junk folders to be sure your email system has not placed your welcome email in one of these. Step 2—Enter first name, last name and date of birth. The profile number and email will pull from the link provided in the email. Next, create a user ID and password. Select the checkbox verifying the information is correct and then hit REGISTER. Step 3– Select three security questions and provide answers. These are needed in case your password is forgotten. Step 4—Select on the Main Menu button. Step 5 – View Clinical Information. Step 6—Select the applicable patient account to view (if you are an authorized representative for more than one account, you will see all of them listed here). Step 7—Select applicable account. All accounts for your visits to CVMC will be listed here. Step 8—Your patient summary information will then be shown. This will include information from your admission to the hospital such as test results, medications, allergies, immunizations, and health issues. Step 9—To view another account, select “Clinical Information.” 5
continued... Frequently Asked Questions What is the Patient Portal? The CVMC Patient Portal is an online health document management tool that
in-
cludes a view of clinical data from your Electronic Medical Record (EMR). The clinical data on the Patient Portal includes: Test Results, Medications, Allergies, Immunizations and Health Issues
How do I access the Patient Portal once I have completed the invitation/account set-up process? For future visits to the CVMC Patient Portal after you have completed the initial setup process, you can log in at: https://www.thrivepatientportal.com. Remember, use this link after you have received a portal invite and completed the sign-up process.
Do I need special equipment? No. All you need is access to a computer, an internet connection, and access to the email account that you provided during hospital registration.
How do I set up an account? Step-by-step instructions on how to set up an account are included on the previous page. Once you have entered your information and have been prompted to create a username and password, you will only need your username and password to sign into your Patient Portal account in the future.
Can my family/friends access the information found on my Portal? Yes, but only after you have given them permission. As a patient of CVMC, you can choose to give an authorized representative access to specific hospital visits. You will be asked this information during the admission process.
Who should I contact if I have trouble logging in or accessing the CVMC Patient Portal? If you have trouble logging in or accessing CVMC’s Patient Portal, contact CVMC at 256-401-4626 Monday through Friday from 8 am—4:30 pm CST; you may also leave a message after-hours and someone will call you promptly the next business day.
Will I receive emails after each admission to the hospital? No. After each admission to the hospital a new summary of care document will post to your patient portal. You may access the document any time after you are discharged. Once the initial email has been sent, the patient or authorized representative will not be sent new emails with each new visit.
What if I have questions about my medical records? If you have questions about your medical records, or feel that an error has been made, please contact CVMC’s Medical Records Department at 256-401-4494.
Accessing your account: To access your account or additional accounts at a later time, please visit: http://mymedicalencounters.com. If you have any questions or concerns regarding this new initiative you can call us at 256-401-4626 and/or contact the Centers for Medicare and Medicaid Services website: http://cms.gov, and search “Meaningful Use.” The CVMC Patient Portal relates to services provided at Coosa Valley Medical Center ONLY and will not include health information from any other health care facilities that you may have utilized for health services. 6
Speak up…
If you do not understand something or if something does not seem right. If you speak another language and would like a translator. If you need medical forms explained. If you think you are being confused with another patient. If you do not recognize a medicine or think you are about to get the wrong medicine. If you are not getting your medicine or treatment when you should. About your allergies and reactions you have had to medicines.
Pay attention…
Check identification (ID) badges worn by doctors, nurses and other staff. Check the ID badge of anyone who asks to take your newborn baby. Do not be afraid to remind doctors and nurses to wash their hands.
Educate yourself…
So you can make well-informed decisions about your care. Ask doctors and nurses about their training and experience treating your condition. Ask for written information about your condition. Find out how long treatment should last, and how you should feel during treatment. Ask for instruction on how to use your medical equipment.
Advocates (family members and friends) can help...
Give advice and support—but they should respect your decisions about the care you want. Ask questions, and write down important information and instructions for you. Make sure you get the correct medicines and treatments. Go over the consent form, so you all understand it. Get instructions for follow-up care, and find out who to call if your condition gets worse.
Know about your medicine...
Find out how it will help. Ask for information about it, including brand and generic names. Ask about side effects. Find out if it is safe to take with your other medicines and vitamins. Ask for a printed prescription if you can not read the handwriting. Read the label on the bag of intravenous (IV) fluid so you know what is in it & that it is for you. Ask how long it will take the IV to run out.
Use a quality health care organization that...
Has experience taking care of people with your condition. Your doctor believes has the best care for your condition. Is accredited, meaning it meets certain quality standards. Has a culture that values safety and quality, and works every day to improve care.
Participate in all decisions about your care...
Discuss each step of your care with your doctor. Don’t be afraid to get a second or third opinion. Share your up-to-date list of medicines and vitamins with doctors and nurses. Share copies of your medical records with your health care team.
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“THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.” (Effective September 23, 2013) The Sylacauga Health Care Authority d/b/a Coosa Valley Medical Center (“Provider”) is dedicated to protecting your health information. Provider is required by law to maintain the privacy of protected health information, to provide you adequate notice of your rights and our legal duties and privacy practices with respect to protected health information and to notify affected individuals following a breach of unsecured protected health information. 45 CFR § 164.520. “Protected Health Information” is defined at 45 CFR § 164.501 and includes past, present and future information created or received by Provider. It also includes demographic information that may identify you and that relates to your past, present or future medical condition (physical or mental), the providing of health care to you, or payment for the health care treatment. We will use or disclose Protected Health Information in a manner that is consistent with this notice.
WHAT IS THIS NOTICE? Provider maintains a record (paper/electronic file) of the information we receive and collect about you and of the care we provide to you. This record includes physicians’ orders, assessments, medication lists, clinical progress notes and billing information. This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights regarding your Protected Health Information. As required by law, Provider maintains policies and procedures about our work practices, including how we coordinate care and services provided to our patients. These policies and procedures include how we create, receive, access, transmit, maintain and protect the confidentiality of all health information in our workforce and with contracted business associates and/or subcontractors; security of Provider’s building and electronic files; and how we educated staff on privacy of patient information.
PERMITTED AND REQUIRED USES AND DISCLOSURES. As our patient, information about you must be used and disclosed to other parties for purposes of treatment, payment and health care operations. Examples of information that must be disclosed: Treatment: Providing, coordinating or managing health care and related services, consultation between health care providers relating to a patient or referral of a patient for health care from one provider to another. For example, we may need to give information to doctors, nurses, technicians, medical students or other personnel who are involved in taking care of you both in and outside of Provider’s office. Payment: Billing and collecting for services provided, determining plan eligibility and coverage, utilization review (UR), precertification, and medical necessity review. For example, we may need to give information to your health plan about surgery you received so that your health plan will pay us or reimburse you for the surgery. We may also tell your health plan about a treatment you are going to receive in order to obtain prior approval or to determine whether your plan will cover the treatment. Health Care Operations: General agency administrative and business functions, quality assurance/improvement activities; medical review; auditing functions; developing clinical guidelines; determining the competence or qualifications of health care professionals; evaluating agency performance; conducting training programs with students or new employees; licensing, survey, certification, accreditation and credentialing activities; internal auditing; and certain fundraising activities, if applicable, and with your authorization, marketing activities. For example, we may disclose medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We also may disclose information to doctors, nurses, technicians, medical students, and other personnel for review and learning purposes. The medical information we have may be combined with medical information from other sources in order to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information so that others may use it to study health care and health care delivery without learning who the specific patients are. 10
continued... The following uses and disclosures do not require your consent, and include, but are not limited to, a release of information contained in financial records and/or medical records, including information concerning communicable diseases such as Human Immune Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), drug/alcohol abuse, psychiatric diagnosis and treatment records and/or laboratory test results, if applicable, medical history, treatment progress and/or any other related information as permitted by state law to: 1.
Your insurance company, self-funded or third-party health plan, Medicare, Medicaid or any other person or entity that may be responsible for paying or processing for payment any portion of your bill for services;
2.
Any person or entity affiliated with or representing us for purposes of administration, billing and quality and risk management;
3.
Any hospital, nursing home or other health care facility to which you may be admitted;
4.
Any assisted living or personal care facility of which you are a resident;
5.
Any physician providing you care;
6.
Licensing and accrediting bodies, including the information contained in the OASIS Data Set to the state agency acting as a representative of the Medicare/Medicaid program;
7.
Contact you to raise funds for Provider; you will be given the right to opt out of receiving such communications, if applicable;
8.
Any business associate or institutionally related foundation for the purpose of raising funds for the agency (information may include: demographics – name, address, contact information, age, gender, date of birth; dates of health care provided; department of services; treating physician; outcome information; and health insurance status), if applicable. You will be given the right to opt out;
9.
Refill reminders for drugs, biologicals and/or drug delivery systems that have already been prescribed to you;
10. Marketing communications promoting health products, services and information programs or communications if the communication is made face to face with you or the only financial gain consists of a promotional gift of nominal value provided by Provider; and 11. Other health care providers to initiate treatment.
We are permitted to use or disclose information about you without consent or authorization in the following circumstances: 1.
In emergency treatment situations, if we attempt to obtain consent as soon as practicable after treatment;
2.
Where substantial barriers to communicating with you exist and we determine that the consent is clearly inferred from the circumstances;
3.
Where we are required by law to provide treatment and we are unable to obtain consent;
4.
Where the use or disclosure of medical information about you is required by federal, state or local law;
5.
To provide information to state or federal public health authorities, as required by law to: prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify persons of recalls of products they may be using; notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence (if you agree or when required or authorized by law);
6.
Health care oversight activities such as audits, investigations, inspections and licensure by a government health oversight agency as authorized by law to monitor the health care system, government programs and compliance with civil rights laws;
7.
To business associates regulated under HIPAA that work on our behalf under a contract that requires appropriate safeguards of Protected Health Information;
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continued... 8.
Certain judicial administrative proceedings if you are involved in a lawsuit or a dispute. We may disclose medical information about you in response to a court or administrative order, a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested;
9.
Certain law enforcement purposes such as helping to identify or locate a suspect, fugitive, material witness or missing person, or to comply with a court order or subpoena and other law enforcement purposes;
10. To coroners, medical examiners and funeral directors, in certain circumstances, for example, to identify a deceased person, determine the cause of death or to assist in carrying out their duties; 11. For cadaveric organ, eye or tissue donation purposes to communicate to organizations involved in procuring, banking or transplanting organs and tissues (if you are an organ donor); 12. For certain research purposes under very select circumstances. We may use your health information for research. Before we disclose any of your health information for such research purposes, the project will be subject to an extensive approval process. We may also request your written authorization before granting access to your individually identifiable health information but are not required to do so; 13. To avert a serious threat to health and safety: To prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public, such as when a person admits to participation in a violent crime or serious harm to a victim or is an escaped convict. Any disclosure, however, would only be to someone able to help prevent or lessen the threat; 14. For specialized government functions, including military and veterans' activities, national security and intelligence activities, protective services for the President, foreign heads of state and others, medical suitability determinations, correctional institution and custodial situations; and 15. For Workers' Compensation purposes: Workers’ compensation or similar programs provide benefits for work-related injuries or illness. We are permitted to use or disclose information about you provided you are informed in advance and given the opportunity to individually agree to, prohibit, or restrict the use or disclosure in the following circumstances: 1.
Use or disclosure of a directory (including name, location, condition described in general terms and/or religious affiliation) of individuals served by Provider;
2.
Provide proof of immunization to a school that is required by state or other law to have such proof with agreement to disclosure by parent, guardian or other person acting in loco parentis of the individual, if the individual is an emancipated minor; and
3.
Provide a family member, relative, friend, or other identified person, prior to, or after your death, the information relevant to such person’s involvement in your care or payment for care; to notify a family member, relative, friend, or other identified person of your location, general condition or death.
Other uses and disclosures not covered in this notice will be made only with your written authorization. Authorization is required and may be revoked, in writing, at any time, except in limited situations, for the following disclosures: 1. 2. 3. 4.
Marketing of products or services or treatment alternatives, including any subsidized treatment communications, that may be of benefit to you when we receive direct payment from a third party for making such communications, other than as set forth above with regard to face-to-face communications and promotional gifts of nominal value; Psychotherapy notes under most circumstances, if applicable; and Any sale of Protected Health Information resulting in financial gain by Provider unless an exception is met.
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continued... YOUR RIGHTS You have the right, subject to certain conditions, to:
Request restrictions on uses and disclosures of your Protected Health Information for treatment, payment or health care operations. However, we are not required to agree to any requested restriction. Restrictions to which we agree will be documented. Agreements for further restrictions may, however be terminated under applicable circumstances (e.g., emergency treatment). We must agree to your request to restrict disclosure of Protected Health Information about you to a health plan if: 1) the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and 2) the Protected Health Information pertains solely to a health care item or service for which you or someone on your behalf paid the covered entity in full. (164.522 Rights to request privacy protection for Protected Health Information).
Confidential communication of Protected Health Information. We will arrange for you to receive Protected Health Information by reasonable alternative means or at alternative locations. Your request must be in writing and must contain a statement that disclosure of all or part of the information to which the request pertains could endanger you. We do not require an explanation for the request as a condition of providing communications on a confidential basis and will attempt to honor reasonable requests for confidential communications. If you request your Protected Health Information to be transmitted directly to another person designated by you, your written request must be signed and clearly identify the designated person and where the copy of Protected Health Information is to be sent.
Inspect and obtain copies of Protected Health Information that is maintained in a designated record set, except for psychotherapy notes, information compiled in reasonable anticipation of, or for use in, a civil, criminal or administrative action or proceeding, or Protected Health Information that may not be disclosed under the Clinical Laboratory Improvements Amendments of 1988 [42 USC § 263a and 45 CFR 493 § (a)(2)]. If you request a copy of your health information, we will charge a reasonable, cost-based fee, that includes only the cost of labor for copying, supplies, postage, if applicable, and preparing an explanation or summary of the projected health information if agreed to, in accordance with applicable state and federal regulations. If the requested Protected Health Information is maintained electronically and you request an electronic copy, we will provide access in an electronic format you request, if readily producible, or if not, in a readable electronic form and format mutually agreed upon. IF YOU REQUEST AN ELECTRONIC COPY, PROVIDER HEREBY EXPRESSLY DISCLAIMS ALL DUTIES AND RESPONSIBILITY FOR THE SECURITY AND PROTECTION OF SUCH INFORMATION ONCE TRANSMITTED TO YOU AND HAS NO CONTROL OVER ACCESS TO THAT INFORMATION AFTER THE TRANSMISSION TO YOU THEREOF. ALL SUCH INFORMATION MAINTAINED BY PROVIDER WILL CONTINUE TO BE SECURED AND PROTECTED AS REQUIRED BY APPLICABLE LAW. If we deny access to Protected Health Information, you will receive a timely, written denial in plain language that explains the basis for the denial, your review rights and an explanation of how to exercise those rights. If we do not maintain the medical record, we will tell you where to request the Protected Health Information if we have knowledge thereof.
Request to amend Protected Health Information for as long as the Protected Health Information is maintained in the designated record set. A request to amend your record must be in writing and must include a reason to support the requested amendment. We will act on your request within sixty (60) days of receipt of the request. We may extend the time for such action by up to thirty (30) days, if within the initial sixty (60) days we provide you with a written explanation of the reasons for the delay and the date by which we will complete action on the request.
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continued...
We may deny the request for amendment if the information contained in the record was not created by us, unless you provide a reasonable basis for believing the originator of the information is no longer available to act on the requested amendment; is not part of the designated medical record set; would not be available for inspection under applicable laws and regulations; or the record is accurate and complete. If we deny your request for amendment, you will receive a timely, written denial in plain language that explains the basis for the denial, your rights to submit a statement disagreeing with the denial and an explanation of how to submit that statement. Receive an accounting of disclosures of Protected Health Information made by Provider for up to six (6) years prior to the date on which the accounting is requested for any reason other than for treatment, payment or health operations and other applicable exceptions. The written accounting includes the date of each disclosure, the name of the entity or person who received the Protected Health Information and, if known, the address, a brief description of the information disclosed and a brief statement of the purpose of the disclosure or a copy of the written request for disclosure. We will provide the accountings within sixty (60) days of receipt of a written request. However, we may extend the time period for providing the accounting by thirty (30) days if within the initial sixty (60) days we provide you with a written statement of the reasons for the delay and the date by which you will receive the information. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests within the applicable 12-month period may be subject to a reasonable cost-based fee, which fee information will be provided to you in advance of fulfilling your request; you will also have an opportunity upon receipt of fee information to withdraw or modify your request for the accounting in order to avoid or reduce the applicable fee. Receive notification of any breach in the acquisition, access, use or disclosure of unsecured Protected Health Information by Provider, its business associates and/or subcontractors. Obtain a paper copy of this notice from us upon request, even if you had previously agreed to receive this notice electronically. We reserve the right to amend this notice of privacy practices at any time.
COMPLAINTS If you believe that your privacy rights have been violated, you may complain to Provider or to the Secretary of the U.S. Department of Health and Human Services. There will be no retaliation against you for filing a complaint. The complaint should be filed in writing, and should state the specific incident (s) in terms of subject, date and other relevant matters. A complaint to the Secretary must be filed in writing within 180 days of when the act or omission complained of occurred, and must describe the acts or omissions believed to be in violation of applicable requirements. 45 CFR § 160.306. For further information regarding filing a complaint, contact: Privacy Officer The Sylacauga Health Care Authority d/b/a Coosa Valley Medical Center Roland Thacker Privacy Compliance Officer (256) 401-4534
EFFECTIVE DATE This notice is effective: September 23, 2013. We are required to abide by the terms of the notice currently in effect, but we reserve the right to change these terms as necessary for all Protected Health Information that we maintain. If we change the terms of this notice (while you are receiving service), we will promptly revise and distribute a revised notice to you as soon as practicable by mail, e-mail (if you have agreed to electronic notice), hand delivery or by posting on our website at http://www.cvhealth.net. If you require further information about matters covered by this notice or to make any of the foregoing requests, please contact: Privacy Officer The Sylacauga Health Care Authority d/b/a Coosa Valley Medical Center Roland Thacker Privacy Compliance Officer (256) 401-4534 14
A Simple and Smart Way to Take Care of Your Care Coosa Valley Medical Center wants you to know that you have a right to make an advance directive for healthcare. In fact, we encourage you to do so. Your nurse will ask you if you have an advance directive. If you brought your advance directive with you to the hospital, the nurse can place a copy in your medical record. If you do not have an advanced directive with you, we will ask you to have a family member bring it to the hospital.
What is an advance directive? An advance directive is used to tell your doctor and family what kind of medical care you want if you are too sick or hurt to talk or make decisions. If you do not have an advance directive, certain members of your family will have to decide on your care. You must be 19 years of age to set up an advance directive. You must be able to think clearly and make decisions for yourself when you set it up. You do not need a lawyer to set one up, but you may want to talk with a lawyer before you take this important step. Whether or not you have an advance directive, you have the same right to get the care you need. In Alabama, you can set up an advance directive for healthcare. The choices you have include: 
A living will is used to write down ahead of time what kind of care you do or do not want if you are too sick to speak for yourself.

A proxy can be part of a living will. You can pick a proxy to speak for you and make the choices you would make if you could. If you pick a proxy, you should talk to that person ahead of time. Be sure that your proxy knows how you feel about different kinds of medical treatments. Another way to pick a proxy is to sign a durable power of attorney for healthcare. The person you pick does not need to be a lawyer.
You can choose to have any or all of these three advance directives: living will, proxy and/or durable power of attorney for healthcare. Hospitals, home health agencies, hospices and nursing homes usually have forms you can fill out if you want to set up a living will, pick a proxy or set up a durable power of attorney for health care. If you have questions, you should ask your own lawyer or call your local Council on Aging for help.
When you set up an advance directive, be sure to sign your name and write the date on any form or paper you fill out. Talk to your family and doctor now so they will know and understand your choices. Give them a copy of what you have signed. If you go to the hospital, give a copy of your advance directive to the person who admits you to the hospital.
What do I need to decide? You will need to decide if you want treatments or machines that will make you live longer even if you will never get better. An example of this is a machine that breathes for you. Some people do not want machines or treatments if they cannot get better. They may want food and water through a tube or pain medicine. With an advance directive, you decide what medical care you want.
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Talk to your doctor and family now. The law says doctors, hospitals and nursing homes must follow advance directives, living wills and proxies. Before you set up an advance directive, talk to your doctor. Find out if your doctor is willing to go along with your wishes. If your doctor does not feel he or she can carry our your wishes, you can ask to go to another doctor, hospital or nursing home. Once you decide on the care you want or do not want, talk to your family. Explain why you want the care you have decided on. Find out if they are willing to let your wishes be carried out. Family members do not always want to go along with an advance directive. This often happens when family members do not know about a patient’s wishes ahead of time or if they are not sure about what has been decided. Talking with your family ahead of time can prevent this problem.
You can change your mind any time. As long as you can speak for yourself, you can change your mind any time about you have written down. If you make changes, tear up your old papers and give copies of any new forms or changes to everyone who needs to know.
For Help or More Information: Alabama Commission on Aging: 1-800-243-5463 Choice in Dying: 1-800-989-9455
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